Organization
CORNELSON PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNA CORNELSON (OWNER)
(405) 618-1933
Entity
Organization
Contact information
Practice address
6020 NW 120TH CT, OKLAHOMA CITY, OK 73162-1729
(405) 751-9955
Mailing address
12104 DORNICK DR, OKLAHOMA CITY, OK 73162-6905
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/06/2020
Last updated
09/11/2020
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